US20110143898A1 - Patient support apparatuses with exercise functionalities - Google Patents

Abstract

A patient support apparatus generally includes a base frame and a support deck supported on the base frame, the support deck comprising a seat portion. A segmented patient support surface is slidably coupled to the support deck. A lift system is coupled to the support deck and the segmented patient support surface. The lift system raises, lowers and tilts the support deck with respect to the base frame, and pivots a torso support segment of the support surface with respect to a leg support segment of the support surface. A foot plate assembly is removably positioned proximate a free end of the support deck, the foot plate assembly receiving a patient's feet when a patient is positioned on the segmented patient support surface thereby enabling the patient to slide the segmented patient support surface relative to the support deck.

Description

CROSS REFERENCE TO RELATED APPLICATIONS
• The present specification claims priority to U.S. Provisional Application Ser. No. 61/284,178 filed Dec. 14, 2009 and entitled “HOSPITAL BED WITH CHAIR EGRESS, TILT TABLE, AND LEG PRESS FUNCTIONS,” the entirety of which is incorporated herein by reference.
TECHNICAL FIELD
• The present specification generally relates to patient support apparatuses and, more specifically, to patient support apparatuses which are adjustable from a horizontal orientation to an egress orientation, a tilt orientation, and an exercise orientation useful for rehabilitating patients with severe muscle weakness.
BACKGROUND
• Recent medical advances have allowed more patients to survive serious injuries or disease processes than ever before. Unfortunately, the period of bed rest required for recovery often leads to severe deterioration of muscle strength and a corresponding inability of the patient to support full body weight upon standing. It is challenging for rehabilitation specialists to help these patients regain the ability to stand and begin ambulation, and the challenge is especially great for obese patients. A common technique in conventional practice is to summon as many colleagues as practical to lift and maneuver the weakened patient to a standing position while he or she attempts to bear full weight through the lower extremities. This technique is not only dangerous, because of the risk of a fall, but it is also psychologically degrading for the patient as the activity reinforces the patient's dependence on others.
• Hospital beds have evolved over the years from conventional beds that lie flat to beds that convert into a chair position, allowing patients to begin standing from the foot of the bed. Examples of these beds are the Total Care bed by Hill-Rom (Batesville, Ind.) and the BariKare bed by Kinetic Concepts Incorporated (San Antonio, Tex.). Although this advancement in hospital bed design allows patients to sit upright and egress from the foot end of the bed, it is still a passive event requiring no effort by the patient. The sitting position does not improve a patient's leg strength and does little for preparing a patient for upright standing. Patients are still required to be lifted by hospital staff as the patient's leg muscles do not have adequate strength to support their weight.
• An alternative to mobilizing patients with manpower is to use a tilt table. A tilt table resembles a stretcher that can be tilted gradually from a horizontal to a vertical position. The patient is transferred laterally from a hospital bed to the tilt table surface and secured to the tilt table with straps placed across the knees and waist. The table's surface is then tilted to the desired inclination. A footboard at the lower end prevents the patient from sliding off the table and allows graded weight-bearing through the legs. The benefits of tilt table standing include a gradual retraining of the cardiovascular system to the demands of the body's upright position and the re-education of the balance mechanisms affected by long periods of bed rest.
• Unfortunately, tilt tables have a significant limitation. The tilt table is only able to bring the patient to an upright position while simultaneously restricting movement of the lower extremities. This restriction prevents movement through the range-of-motion of the knee joints and greatly limits strengthening of the lower extremity muscles, because the legs are strapped to the table. The conventional tilt table design has no mechanism to enable a patient to perform lower or upper extremity exercise for strengthening or conditioning.
• A recent advancement in rehabilitation of severely weak hospitalized patients is a therapeutic exercise device for hospitalized patients invented by this inventor (U.S. Pat. No. 7,597,656) and assigned to Encore Medical Asset Corporation (Henderson, Nev.). The exercise device, known as the Moveo XP, involves a sliding carriage on a portable base that allows patients to perform a leg press exercise using a portion of their body weight, depending on the incline of the table. This technique allows patients to begin partial-body-weight strengthening until they have adequate strength to begin standing.
• Unfortunately, the Moveo XP has its limitations. Disadvantages with this device are that it requires additional storage space, is difficult to get into small hospital rooms, and can be difficult to transfer patients on and off the table, especially for patients of size. For example, the risk of staff injury during the transfer of a morbidly obese patient outweighs the potential benefit of a 15 to 20 minute workout on the table. Further, during these times of hospital staff cutbacks, assistance to perform the lateral transfers on and off the table is often times unavailable. Lastly, the device is not meant to function as a hospital bed as it does not have adequate cushioning, the ability to perform Trendelenburg with the head lower than the feet for patients with low blood pressure, and does not have side rails for patient safety.
• Accordingly, a need exists for alternative patient support apparatuses, such as hospital beds and/or patient care beds which enable a patient to perform rehabilitation exercises.
SUMMARY
• In one embodiment, a patient support apparatus with closed chain exercise functionalities includes a base frame and a support deck having a seat portion supported on the base frame. The patient support apparatus also includes a segmented patient support surface having a torso support segment and an upper leg support segment. The torso support segment and the upper leg support segment are slidably coupled to the support deck such that the torso support segment and the upper leg support segment are freely slidable with respect to the support deck. The torso support segment is also pivotable with respect to the upper leg support segment. A lift system is coupled to the support deck and the segmented patient support surface. The lift system raises, lowers and tilts the support deck with respect to the base frame, and pivots the torso support segment with respect to the upper leg support segment. A foot plate assembly is removably positioned proximate a free end of the support deck. The foot plate assembly receives the feet of a patient when the patient is positioned on the segmented patient support surface thereby enabling the patient to slide the segmented patient support surface relative to the support deck to perform a closed chain exercise.
• In another embodiment, a patient support apparatus with closed chain exercise functionalities includes a base frame and a support deck supported on the base frame, the support deck comprising a seat portion. A segmented patient support surface is supported on the support deck and includes a torso support segment and an upper leg support segment, wherein the torso support segment is pivotable with respect to the upper leg support segment. A lift system is coupled to the support deck and the segmented patient support surface, the lift system raising, lowering and tilting the support deck with respect to the base frame, and pivoting the torso support segment with respect to the upper leg support segment. A stationary exercise support is positioned to be engaged by a patient when the patient is positioned on the segmented patient support surface such that the patient can perform a closed chain exercise while positioned on the segmented patient support surface.
• In yet another embodiment, a patient support apparatus with closed chain exercise functionalities includes a base frame and a support deck supported on the base frame, the support deck includes a seat portion and a leg portion pivotally coupled to an end of the seat portion. A segmented patient support surface comprising an upper leg support segment is slidably coupled to the support deck such that the upper leg support segment is freely slidable with respect to the support deck. A lift system is coupled to the support deck and the segmented patient support surface, the lift system raising, lowering and tilting the support deck with respect to the base frame and pivoting the leg portion with respect to the seat portion. A foot plate assembly is removably positioned proximate a free end of the leg portion of the support deck, the foot plate assembly receiving the feet of a patient when the patient is positioned on the segmented patient support surface thereby enabling the patient to slide the segmented patient support surface relative to the support deck to perform a closed chain exercise.
• These and additional features provided by the embodiments described herein will be more fully understood in view of the following detailed description, in conjunction with the drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
• The embodiments set forth in the drawings are illustrative and exemplary in nature and not intended to limit the subject matter defined by the claims. The following detailed description of the illustrative embodiments can be understood when read in conjunction with the following drawings, where like structure is indicated with like reference numerals and in which:
• FIG. 1 shows a perspective view of a patient support apparatus according to one or more embodiments shown and described herein;
• FIG. 2 is an exploded perspective view of the base frame and frame covers of the patient support apparatus ofFIG. 1 according to one or more embodiments shown and described herein;
• FIG. 3 is an exploded perspective view of the base frame, load frame and scale mechanism of the patient support apparatus ofFIG. 1 according to one or more embodiments shown and described herein;
• FIG. 4 is an exploded perspective view of the load frame of the patient support apparatus ofFIG. 1 according to one or more embodiments described herein;
• FIG. 5 is a perspective view of the load frame ofFIG. 4 according to one or more embodiments shown and described herein;
• FIG. 6 is a side view of the patient support apparatus ofFIG. 1 with the head cushion in an inclined position according to one or more embodiments shown and described herein;
• FIG. 7 is a side view of the patient support apparatus ofFIG. 1 with the head assembly inclined with respect to the base frame and the head cushion inclined with respect to the head assembly according to one or more embodiments shown and described herein;
• FIG. 8 is a side view of the patient support apparatus ofFIG. 1 configured in the reclined chair orientation according to one or more embodiments shown and described herein;
• FIG. 9 is a side view of the patient support apparatus ofFIG. 1 in the egress orientation according to one or more embodiments shown and described herein;
• FIG. 10 is a side view of the patient support apparatus ofFIG. 1 in the exercise orientation according to one or more embodiments shown and described herein;
• FIG. 11A is a side view of the patient support apparatus ofFIG. 1 in the upper extremity exercise orientation according to one or more embodiments shown and described herein;
• FIG. 11B is a side view of the patient support apparatus ofFIG. 1 in the upper extremity exercise orientation according to one or more embodiments shown and described herein;
• FIG. 12 is a perspective view of the patient support apparatus ofFIG. 1 showing use of the bed in the unilateral lower extremity exercise orientation by an amputee patient according to one or more embodiments shown and described herein;
• FIG. 13 is a side view of the patient support apparatus ofFIG. 1 showing use of the tilt orientation by a patient restrained with various body straps;
• FIG. 14A is a top view of a portion of the patient support apparatus ofFIG. 1 showing the telescopic linear rails according to one or more embodiments shown and described herein;
• FIG. 14B schematically depicts a portion of a range of motion stop assembly according to one or more embodiments shown and described herein;
• FIG. 15 is a cross-sectional view of the telescopic linear rails of the carriage according to one or more embodiments shown and described herein;
• FIG. 16 is a bottom view of the carriage of the patient support apparatus ofFIG. 1 according to one or more embodiments shown and described herein;
• FIG. 17 is a side view of the amputee support pad attachment to the carriage according to one or more embodiments shown and described herein;
• FIG. 18 is a bottom view of a foot plate according to one or more embodiments described herein;
• FIG. 19 is a side view of the brake assembly according to one or more embodiments shown and described herein;
• FIG. 20 is a perspective view of the locking mechanism on the carriage and range-of-motion stopping mechanism according to one or more embodiments shown and described herein;
• FIG. 21 is a perspective view of the pendants for controlling the patient support apparatus ofFIG. 1 according to one or more embodiments shown and described herein;
• FIG. 22 is a side view of the side rails of the patient support apparatus according to one or more embodiments shown and described herein;
• FIG. 23 is a perspective view of the adjustable handles mounted on the side rail according to one or more embodiments shown and described herein;
• FIG. 24 is a block diagram schematically depicting a control system of the patient support apparatus ofFIG. 1, according to one or more embodiments shown and described herein; and
• FIGS. 25A-25D are partial side views of one embodiment of a patient support apparatus according to one or more embodiments shown and described herein.
DETAILED DESCRIPTION
• FIG. 1 generally depicts one embodiment of a patient support apparatus, such as a hospital bed, a patient care bed or the like, with closed-chain exercise functionalities. The patient support apparatus generally includes a base frame, a support deck, a segmented patient support surface, a lift system and a removable stationary exercise support. The support deck is mounted to the base frame such that the support deck can be raised, lowered and/or tilted relative to the base frame with the lift system. The segmented patient support surface is slidably coupled to the support deck such that the segmented patient support surface is freely slidable with respect to the support deck. The stationary exercise support is removably positioned on the support deck and is oriented to such that a patient can engage the stationary exercise support when the patient is positioned on the segmented patient support surface thereby enabling the patient to perform a closed chain exercise. The patient support apparatus and various features of the patient support apparatus will be described in more detail herein.
• As used herein, the term “deconditioned” and similar terms refer to a condition of a person who, due to injury, disease or other circumstance, is in a weakened state. Such persons may suffer from lower extremity paralysis or an altered mental state, and may be unable to support their body weight in a standing position.
• Referring toFIG. 1, one embodiment of apatient support apparatus29 is schematically depicted. Thepatient support apparatus29 can be used for rehabilitation of severely deconditioned patients, including deconditioned bariatric patients. Thepatient support apparatus29 generally comprises abase frame61, asupport deck50, a segmentedpatient support surface11, a lift system170 (depicted inFIGS. 4 and 5) and a stationary exercise support, such asfoot plate assembly41.
• In one embodiment, thebase frame61 and theload frame62 utilized may be similar to the base frame and load frame disclosed in U.S. Pat. No. 7,426,760. For example, referring toFIGS. 2-3, the description of which generally corresponds to FIGS. 3 and 4 of U.S. Pat. No. 7,426,760 and the associated description contained therein, thebase frame61 may generally compriselongitudinal beams65 and66 andtransverse elements63 and64.Base frame61 further comprises a plurality ofcasters34,35,36, and37 conventionally located proximate the four corners of thebase frame61. Lockingmechanisms38 and39 are provided for at least thefront casters35,36, respectively. However, it should be understood that therear casters34,37 may be provided with similar locking mechanisms. The locking mechanisms may be set to prevent either rotation and/or steering of thecasters35,36, thereby holding the base frame61 (and patient support apparatus) stationary with respect to the floor, as is conventional with many hospital bed frames. A plurality of accessory weldments, such asaccessory weldments68,69,70 and71 are attached to thebase frame61 onlongitudinal beams65,66 (FIG. 2). In the embodiment of thebase frame61 depicted inFIGS. 2 and 3, theaccessory weldments68,69,70,71 are attached proximate the ends of thelongitudinal beams65,66. However, it should be understood that the accessory weldments may be attached at various locations along thelongitudinal beams65,66 or even on thetransverse elements63,64 of the base frame. The accessory weldments68,69,70,71 receive various attachments, such asstanchions42,44 on which various accessories may be supported, such as intravenous injection (IV) holders, standard traction frames, and the like. In the embodiments shown inFIGS. 1-3,stanchions42,44 include hand holds42″-44″ which may be used to facilitate patient entrance or exit from thepatient support apparatus29. However, in other embodiments described herein,accessory weldments68,69,70,71 may be used to receive various stationary exercise supports, such a upper extremity exercise assemblies, which may be used in conjunction with thepatient support apparatus29 to perform closed chain exercises to strengthen the upper and/or lower body of a patient, as will be described in more detail herein. Thebase frame61 may further comprise one or more garnish covers460,470,480 removably positioned over the various operating mechanisms of thepatient support apparatus29.
• Referring now to FIGS.1 and3-5, thelift system170 includesload frame62 which couples thelift system170 to thebase frame61. It is noted thatFIGS. 3-5 and the following description generally correspond to FIGS. 4-5 of U.S. Pat. No. 7,426,760 and the associated description of those figures contained therein. Theload frame62 supports the various linear actuators (such as jack motors and the like) and related mechanical and electrical components which facilitate raising, lowering and tilting thesupport deck50 with respect to thebase frame61 and articulating various portions and/or segments of both thesupport deck50 and the segmentedpatient support surface11. Theload frame62 generally compriseslongitudinal beams72,73 andtransverse elements74,75. Additionaltransverse elements76,77support jack motors90,92, within theload frame62, respectively. The operation ofjackmotors90,92 with respect to the operation of thepatient support apparatus29 will be described further herein.
• In the embodiments described herein, linear variable displacement transducers (LVDTs)88 and89 are disposed between theload frame62 and thebase frame61 such that any loads positioned on the load frame (i.e., a patient) is registered by the LVDTs which output a signal indicative of the load to thecontrol unit174. For example, in one embodiment, theload frame62 andbase frame61 are coupled as described in U.S. Pat. No. 4,793,428, which is herein incorporated by reference. In particular, thebase frame61 includes a pair ofdisplacement transmitting members84,85 which are respectively connected betweentransverse elements63 and74 and64 and75 withflexures78,79,80 and81 and243,244,245 and246. More specifically, transmittingmember84 is attached totransverse element63 withflexure246 andtransverse element74 withflexure81.Bar elements82,83 are connected tomembers84 and85 in a cantilevered manner such that, when a load is applied to theload frame62, the load is communicated to thebar elements82,83 through the transmitting members and flexures. The displacement of thebar elements82,83 is limited bysprings86,87. The displacement of thebar elements82,83 is measured with theLVDTs88,89 which output a signal in direct proportion to the weight of the load frame, and all which is supported thereon, to controlunit174. Theload frame62 further comprises alocking mechanism67 which secures theload frame62 to thebase frame61 during transport ofpatient support apparatus29.
• Referring now toFIGS. 1,3-5 and7, the mechanical and electrical mechanism which facilitate raising, lowering and tilting thesupport deck50 relative to thebase frame61 are schematically depicted. Tilting of thesupport deck50 relative to thebase frame61 may also be referred to herein as orienting the support deck in a Trendelenburg orientation or a reverse Trendelenburg orientation. In a Trendelenburg orientation, a head of thesupport deck50 is lower than a foot of thesupport deck50 while in a reverse Trendelenburg orientation, the foot of thesupport deck50 is lower that the head of the support deck. To facilitate raising, lowering and tilting thesupport deck50 relative to the base frame, theload frame62 includes ahead torque arm106 andfoot torque arm110, each of which are pivotally attached to loadframe62. Adeck frame150, to which thesupport deck50 is pivotally attached, is coupled to thehead torque arm106 and thefoot torque arm110 withlinkage members102,105,108, and109. Specifically, thefoot torque arm110 is pivotally connected tolinkage members108,109 atlocations101,107, respectively, using bushings and other conventional hardware. Thehead torque arm106 is mechanically coupled tojack motor90 withjack sleeve91 such that, when thejack motor90 is actuated, the rotation of thejack motor90 is translated to thehead torque arm106 through thejack sleeve91 thereby rotating thehead torque arm106 aboutpivots106′ and106″. Similarly, thefoot torque arm110 is mechanically coupled tojack motor92 withjack sleeve93 such that, when thejack motor92 is actuated, the rotation of thejack motor92 is translated to thefoot torque arm110 through thejack sleeve93 thereby rotating thefoot torque arm110 aboutpivots110′ and110″. In the embodiments described herein, thejack motors90,92 andcorresponding jack sleeves91,93 may be linear actuators, such as linear actuators produced by Linak, or any other similar linear actuator. Thejack motors90,92 are attached to thetransverse members76,77 ofload frame62 with torque arm pins95,97 affixed bycotter pins96 and98.
• Extension of thejack sleeve93 byjack motor92 causes thefoot torque arm110 to pivot relative to loadframe62. The rotation of thefoot torque arm110, relative to theload frame62 articulates thelinkage members108,109 either upward or downward, depending on the direction of rotation of thejack motor92. Likewise, extension of thejack sleeve91 byjack motor90 causes headtorque arm106 to pivot relative to theload frame62 and articulates thelinkage members102 and105 either upward or downward, depending on the rotation of thejack motor92. Articulation of thelinkage members102,105,108 and109 raises, lowers and/or tilts thesupport deck50 with respect to thebase frame61.
• In embodiments where thelinkage members102,105,108 and109 are uniformly raised byjack motors90,92 (i.e., the “BED UP” function of the control pendant, described further herein), the head and foot of thesupport deck50 are uniformly raised. Similarly, in embodiments where thelinkage members102,105,108 and109 are uniformly lowered byjack motors90,92 (i.e., the “BED DOWN” function of the control pendant, described further herein), the head and foot of thesupport deck50 are uniformly lowered.
• Embodiments where one jack motor is rotated to a greater or lesser extent than the other results in the support deck being positioned in either a Trendelenburg orientation or a reverse Trendelenburg orientation, as described above. In some embodiments described herein, thelift system170 is capable of positioning the support deck at about a ten degrees Trendelenburg orientation and/or about twelve and one half degrees of reverse Trendelenburg orientation. The Trendelenburg and reverse Trendelenburg orientations may be achieved utilizing the TRENDELENBURG or REVERSE TRENDELENBURG functions of the control pendants, as will be described in more detail herein.
• Referring toFIG. 4, theload frame62 also contains various electronic components of thelift system170. For example, theload frame62 may also contain thetransformer assembly103 andjunction box assembly104 through which power is supplied to the various jack motors of thelift system170. Additionally, inductor-capacitor-resistor (LRC) networks99 and100 can be mounted on theload frame62 so as to conserve space within thejunction box assembly104.LRC networks99 and100 are used for the capacitive startup ofjack motors90 and92 and to protect the power distribution system and control system of thepatient support apparatus29 from back electromotive forces (EMF) generated at initial startup of eitherjack motor90 or92.
• While specific mechanisms (i.e., the load frame, jack motors, etc.) for raising, lowering and tilting the support deck of the patient support apparatus have been described herein as being similar to the base frame and load frame described in U.S. Pat. No. 7,426,760, it should be understood that these mechanisms are exemplary and that it is contemplated that other mechanisms for raising, lowering and tilting the support deck of the patient support apparatus are contemplated. Accordingly, it should be understood that the support deck, carriage, and segmented patient support surface described herein can be adapted for use with various other raising, lowering and tilting mechanisms used in commercially available hospital and patient care beds including, without limitation, the Total Care series of beds manufactured by Hill-Rom of Batesville, Ind. and the BariKare series of beds manufactured by Kinetic Concepts Incorporated of San Antonio, Tex.
• Referring now toFIGS. 6 and 14A, thesupport deck50 of thepatient support apparatus29 generally comprises at least aseat portion52. In the embodiments of thesupport deck50 depicted inFIGS. 6 and 14A, thesupport deck50 further comprises aleg portion53 which is pivotally coupled to an end of theseat portion52 withhinge20. Thehinge20 facilitates pivoting theleg portion53 of thesupport deck50 with respect to theseat portion52 of thesupport deck50 such that the leg portion is positionable between an aligned position wherein theleg portion53 is substantially coplanar with the seat portion52 (as shown inFIG. 6) and at least one declined position wherein theleg portion53 is oriented at a downward angle with respect to theseat portion52 such that theleg portion53 is non-coplanar with the seat portion52 (as shown inFIG. 8).
• Referring toFIGS. 5-7, thesupport deck50 is pivotally coupled to thedeck frame150 of thelift system170 such that thesupport deck50 can be tilted with respect to thebase frame61, as depicted inFIG. 7. For example, in the embodiments of thepatient support apparatus29 described herein, thedeck frame150 of thelift system170 includes a pair oftransverse members114,115 coupled to a pair oflongitudinal members112,113. Thelongitudinal members112,113 andtransverse members114,115 are connected tolinkage members102,105,108 and109 which stabilizedeck frame150. Thedeck frame150 further comprises bearing pivots116,117 positioned at the front (i.e., the foot end) of thedeck frame150. The bearing pivots116,117 are pivotally coupled to theseat portion52 of thesupport deck50 such that theentire support deck50 can be tilted to a tilt angle relative to thebase frame61. In one embodiment, the tilt angle is less than or equal to 90 degrees. In another embodiment, the tilt angle is less than or equal to eighty-five degrees.Tilt jack motor118 is located between weldments tolinkage members102 and105 and directly positioned ontransverse member114 of thedeck frame150. Thejack sleeve119 of thetilt jack motor118 is pivotally coupled to the underside of theseat portion52 of thesupport deck50 with a connectingyoke111 located on the end of thejack sleeve119. Thetilt jack motor118 tilts thesupport deck50 relative to thebase frame61 by extending and retracting thejack sleeve119 relative to theload frame62, as will be described in further detail herein.
• As noted hereinabove, theleg portion53 of thesupport deck50 is pivotable relative to theseat portion52. In order to facilitate controlled, automated pivoting of theleg portion53 of thesupport deck50, thelift system170 further comprises adecline jack motor24. Referring toFIG. 8, thedecline jack motor24 is attached to the underside of theseat portion52 of thesupport deck50. Declinejack motor24 is pivotally attached to theleg portion53 of thesupport deck50 withattachment yolk26 which is positioned on the end ofdecline jack sleeve25. Rotation of thedecline jack motor24 either extends or retracts thedecline jack sleeve25 with respect to theseat portion52 depending on the direction of rotation of thedecline jack motor24. When thedecline jack sleeve25 is retracted, theleg portion53 of thesupport deck50 is pivoted downwards, to one or more declined positions. However, when thedecline jack sleeve25 is extended, the leg portion of thesupport deck50 is pivoted upwards, until the jack sleeve is substantially coplanar with theseat portion52, as described above. In the embodiments described herein, theleg portion53 of thesupport deck50 is pivotal from the aligned position up to a decline angle of about 90 degrees with respect to theseat portion52. Pivoting of theleg portion53 of thesupport deck50 with thedecline jack motor24 may be accomplished using a LEGS UP function or a LEGS DOWN function of a control pendant, as will be described in more detail herein.
• Referring now toFIGS. 1,6 and7, the segmentedpatient support surface11 generally comprises atorso support segment30 and an upperleg support segment31 which are attached to theseat portion52 of thesupport deck50. The segmentedpatient support surface11 may optionally comprise a lowerleg support segment32 and anankle support segment33 attached to theleg portion53 of thesupport deck50. In embodiments where the segmentedpatient support surface11 comprises a lowerleg support segment32, the lowerleg support segment32 is removably attached to the lower leg portion, such as with hook and loop closures, straps, snaps, or any other suitable fastener or fastener system. The lowerleg support segment32 may include handles28 (one shown inFIG. 7) located on both sides to allow removal of lowerleg support segment32 from theleg portion53. Removing the lowerleg support segment32 facilitates the exercise, chair and egress functions of thepatient support apparatus29, as will be discussed further herein. In the embodiments described herein, thesegments30,31,32,33 of the segmentedpatient support surface11 generally comprise a synthetic cover material which is filled with a support material, such as foam, synthetic fibers, natural fibers or the like. Alternatively, the segments may have a traditional mattress structure which incorporates springs and/or combinations of springs with other support materials.
• Referring toFIGS. 6,14A and15, thetorso support segment30 and the upperleg support segment31 of the segmentedpatient support surface11 are slidably coupled to thesupport deck50 such that thetorso support segment30 and the upperleg support segment31 are freely slidable with respect to thesupport deck50. For example, in the embodiments described herein, thetorso support segment30 and the upperleg support segment31 are attached to acarriage18. Thecarriage18 is mounted to a pair of spacedlongitudinal beams123,124 attached to the top surface of theseat portion52 of thesupport deck50 with slidingrails21,22 disposed between the spacedlongitudinal beams123,124 and thecarriage18 such that the carriage18 (and thereforetorso support segment30 and the upper leg support segment31) is slidable with respect to the support deck50 (i.e., the slidingrails21,22 slidably couple thecarriage18 to the spacedlongitudinal beams123,124). Thecarriage18,torso support segment30 and upperleg support segment31 are generally slidable between a head of thesupport deck50 and a foot of thesupport deck50.
• As noted hereinabove, thesupport deck50 comprises aseat portion52 and aleg portion53 which is pivotable with respect to theseat portion52 about ahinge20. The location of thehinge20 prevents the use of conventional, fixed sliding rails which would be affixed to both theseat portion52 and theleg portion53 thereby extending over thehinge20 and preventing theleg portion53 from pivoting with respect to theseat portion52. To overcome this impediment, in some embodiments, the slidingrails21,22 are telescoping sliding rails which are fixedly attached to the spacedlongitudinal beams123,124 on theseat portion52 of thesupport deck50. In these embodiments, the slidingrails21,22 have an extended position where the slidingrails21,22 are positioned over at least a portion of the support deck50 (as shown in dashed lines inFIG. 14A) and a retracted position, where the slidingrails21,22 are not positioned over theleg portion53 of thesupport deck50. In embodiments where the sliding rails are telescoping sliding rails, the sliding rails may be model no. SR28-770 or SR 43-770 ball semi-telescopic rail slides manufactured by Linear Trace SRL (Cinisello, Italy). However, it should be understood that other, similar telescoping sliding rails may be used.
• Referring toFIGS. 6 and 16, thetorso support segment30 of the segmentedpatient support surface11 is pivotable with respect to the upperleg support surface31 such that thetorso support segment30 is positionable with respect to the upperleg support segment31 from a recumbent position, wherein the torso support segment and the upper leg support segment are substantially coplanar (as depicted inFIG. 13), and at least one inclined position, wherein the torso support segment is non-coplanar with the upper leg support segment (as depicted inFIG. 6). In order to facilitate automated pivoting of thetorso support segment30 with respect to the upperleg support segment31, thepatient support apparatus29 may include anincline jack motor55. In one embodiment, thetorso support segment30 is fixedly attached to ahead frame51. In this embodiment, theincline jack motor55 is pivotally coupled to the underside of thehead frame51 withcoupling yolk57. Similarly, theincline jack sleeve56 of theincline jack motor55 is pivotally coupled to across support130 of thecarriage18. Accordingly, extending theincline jack sleeve56 with theincline jack motor55 pivots thetorso support segment30 to at least one inclined position with respect to the upperleg support segment31 while retracting theincline jack sleeve56 with theincline jack motor55 pivots thetorso support segment30 to the recumbent position with respect to the upperleg support segment31.
• Referring again toFIGS. 6,14A,16 and19, in some embodiments, thepatient support apparatus29 may further comprise anadjustable brake assembly49 mounted on thesupport deck50 and engaged with thecarriage18. Theadjustable brake assembly49 assists in preventing the rapid acceleration of thecarriage18 with respect to thesupport deck50, particularly when thesupport deck50 is inclined with respect to thebase frame61. Accordingly, it should be understood that the adjustable brake assembly is capable of regulating the rate of travel of the segmented patient support surface relative to the support deck. In the embodiments described herein, theadjustable brake assembly49 comprises acentrifugal brake48 which is mounted on a threadedpost204 attached to theseat portion52 of thesupport deck50. In the embodiments described herein, the centrifugal brake is a Flo-Guide™ speed controller (commonly referred to as a “pallet brake”), model E40, manufactured and sold by Mallard Manufacturing Corporation of Sterling, Ill. Thecentrifugal brake48 is engaged with awear element131 attached to thecarriage18 such that, as thecarriage18 slides on the slidingrails21,22, thecentrifugal brake48 rolls over thewear element131. When thecarriage18 is moving at a slow rate of speed, the centrifugal brake rolls freely under the carriage. However, when the carriage begins to increase speed, thecentrifugal brake48 resists the increase in speed and slows the carriage to a controlled speed. In the embodiments of theadjustable brake assembly49 shown and described herein, the position of thecentrifugal brake48 is adjustable on the threadedpost204 by rotatingknob5 and thereby increasing or decreasing the frictional force between thecentrifugal brake48 and thewear element131 and, as such, the stopping force of thecentrifugal brake48.
• While theadjustable brake assembly49 has been described herein as comprising acentrifugal brake48, other forms of adjustable braking mechanisms are contemplated. For example, in other embodiments the adjustable braking mechanism may include an electro-magnetic braking device, an eddy current braking device, or any other suitable adjustable braking device.
• Referring toFIGS. 6,14A and20, thecarriage18 can be releasably secured to theseat portion52 of thesupport deck50 withcarriage lock mechanism19. Thecarriage lock mechanism19 comprises aretractable lock pin220 that can be inserted into one of a plurality ofapertures14 formed in theseat portion52 of thesupport deck50. Lifting theretractable lock pin220 and turning the pin counter-clockwise disengages the locking pin from thesupport deck50, allowing free movement of the carriage. Turning the pin clockwise positions the pin229 in anaperture14 and secures the carriage to thesupport deck50. In some embodiments, alock pin sensor172 is positioned on an underside of theseat portion52 and detects when theretractable lock pin220 is positioned in the one of the plurality ofapertures14. Thelock sensor172 may be a pressure sensor, a proximity sensor or any other sensor suitable for detecting the presence of theretractable lock pin220 in an aperture. When theretractable lock pin220 is not positioned in anaperture14, thecarriage18 is free to slide relative to thesupport deck50.
• Referring toFIGS. 14A and 14B, thesupport deck50 may also comprise a range ofmotion stop assembly180. In the embodiment of thesupport deck50 shown inFIGS. 14A and 14B, the range ofmotion stop assembly180 includes a plurality of stop pins182 positioned inapertures8 formed in theseat portion52 of thesupport deck50. Theapertures8 and stoppins182 are positioned in a path of travel of thecarriage18 such that, when astop pin182 is in a raised position, thestop pin182 engages with the carriage thereby preventing thecarriage18 from further motion with respect to the support deck. The stop pins182 comprise ahead184, ashaft186, a retainingball188 disposed in the shaft, and aretaining disc210 surrounding theshaft186. The stop pins182 are positioned in theapertures8 such that, when the stop pins are fully inserted intoseat portion52, theheads184 of the stop pins182 are flush with the top surface of theseat portion52. Theseat portion52 of thesupport deck50 may also include anintermediate substrate208 located on an underside of theseat portion52. Theintermediate substrate208 engages with the retainingball188 when the stop pins182 are in a raised position, thereby maintaining the stop pins182 in a raised position with respect to theseat portion52. The retainingdiscs210 prevent the stop pins from being completely withdrawn from theapertures8.
• In the embodiment of the range ofmotion stop assembly180 depicted inFIGS. 14A and 14B, the range ofmotion stop assembly180 further comprises astop pin sensor168 positioned beneath theseat portion52 of thesupport deck50. Thestop pin sensor168 detects when one or more of the retractable lock pins220 is in a raised position with respect to thesupport deck50. Thestop pin sensor168 may comprise a plurality of pressure sensors, a plurality of proximity sensors, a plurality of continuity sensors, or any other sensor suitable for detecting the state (i.e., raised or lowered) of the stop pins with respect to thesupport deck50.
• Referring toFIGS. 6 and 14A, the lowerleg support segment32 is removably positioned on theleg portion53 of thesupport deck50, as described hereinabove. In order to detect the presence of the lowerleg support segment32 on theleg portion53, theleg portion53 may include acushion sensor166 positioned on the top surface of theleg portion53. Thecushion sensor166 may comprise a proximity sensor, a pressure sensor, a light sensor or any other sensor suitable for detecting the presence of the lowerleg support segment32 on theleg portion53 of thesupport deck50.
• Referring now toFIGS. 1,6 and18, thepatient support apparatus29 further comprises a stationary exercise support, such asfoot plate assembly41, removably positioned on thesupport deck50. In the embodiment of thepatient support apparatus29 shown inFIGS. 1,6 and18, thefoot plate assembly41 is positioned proximate a free end of thesupport deck50. Specifically, thefoot plate assembly41 is positioned proximate a free end of theleg portion53 of thesupport deck50. Thefoot plate assembly41 is positioned to receive the feet of a patient when the patient is positioned on the segmentedpatient support surface11 thereby enabling the patient to slide the segmentedpatient support surface11 relative to thesupport deck50 to perform a closed chain exercise. In the embodiments described herein, thefoot plate assembly41 comprises aright foot plate46 and aleft foot plate47. As depicted inFIG. 18, theright footplate46 is removably positioned in the mountingholes125 and126 formed in theleg portion53 of thesupport deck50. Theleft foot plate47 is attached to thesupport deck50 in a similar manner. Theleft foot plate47 and theright foot plate46 may be removed from thesupport deck50 and stored in footplate storage weldments225,226 located on the base frame61 (right foot plate depicted instorage weldments225,226 inFIG. 9).
• In the embodiments described herein, thefoot plate assembly41 comprises at least one load sensor, such as an LVDT, a piezo-electric pressure transducer or the like, for determining a weight applied to thefoot plate assembly41 by a patient. In the embodiments described herein theleft foot plate47 comprises a left foot load sensor162 (shown inFIG. 12) and theright foot plate46 comprises a rightfoot load sensor164. As will be described in more detail herein, the left foot and rightfoot load sensors164,162 are communicatively coupled to thecontrol unit174.
• While the stationary exercise support assembly has been described herein as comprising a foot plate assembly, is should be understood that other stationary exercise support assemblies may be used. For example, in one embodiment the stationary exercise support assembly may be a pull-up bar assembly, as described further herein.
• Referring to FIGS.1 and22-23, thepatient support apparatus29 further comprises a pair of side rails40 positioned on each side of thesupport deck50. The side rails40 are attached to the underside of thesupport deck50 and have a raised position relative to thesupport deck50, as shown inFIG. 1, and a lowered position relative to thesupport deck50. As shown inFIG. 22,side rail40 further comprises aweight display201. Theweight display201 is communicatively coupled to thecontrol unit174 and is operable to display the weight supported by thesupport deck50 as registered by the LVDTs located in theload frame62 and/or the weight applied to theright foot plate46 and theleft foot plate47 as registered by the right foot plate load sensor and the left foot plate load sensor, respectively.
• Side rail40 can be oriented in the lowered position by pulling the siderail release bar133 thereby permitting access to the segmentedpatient support surface11 by the patient and/or a care giver. The side rails40 may further comprise one or more exercise handles140 slidably coupled to the side rails. The exercise handle140 can be adjusted along the length of the side rail by looseningknob142 that secures the handle to the rail. When not in use, the exercise handle140 can be rotated on the side rail to prevent interference with the patient's movement on the segmented patient support surface.
• Referring now toFIG. 24, thecontrol system200 for the patient support apparatus is schematically depicted. Thecontrol system200 generally comprises acontrol unit174 having amemory176 for storing computer readable and executable instructions and aprocessor178 communicatively coupled to thememory176. Theprocessor178 is operable to read the computer readable and executable instructions stored in thememory176. Thecontrol system200 also comprises auser interface160 which, in the embodiments described herein, includes apatient control pendant45 and a therapy control pendant94 (shown inFIG. 21). The patient control pendant and the therapy control pendant enable a user to control the orientation of various components of the patient support apparatus with various input devices (such as buttons, knobs and the like). Thecontrol unit174 receives signals from theuser interface160 and adjusts the position of the support deck and/or the segmented patient support surface based on the signals received by sending control signals to thejack motors24,55,90,92,118 of thelift system170. Accordingly, it should be understood that thejack motors24,55,90,92,118 are communicatively coupled to thecontrol unit174 and, more specifically, theprocessor178 such that theprocessor178 can operate the jack motors to achieve the desired patient support apparatus configuration based on user inputs to thecontrol pendants45,94.
• Referring now toFIGS. 21 and 24, thependants45,94 of theuser interface160 enable a user to control the configuration of the patient support apparatus. In one embodiment, thepatient control pendant45 includes HEAD UP and HEAD DOWN functions which enable a user to adjust the torso support segment with respect to the upper leg support segment to a recumbent position wherein the torso support segment and the upper leg support segment are substantially coplanar or to at least one inclined position wherein the torso support segment is non-coplanar with the upper leg support segment. Thepatient control pendant45 also includes BED UP and BED DOWN functions which enable the user to raise and lower the support deck and the segmented patient support surface with respect to the base frame. Thepatient control pendant45 may also include FOOT UP and FOOT DOWN functions which enable a user to adjust the leg portion of the support deck to the aligned position wherein the leg portion is substantially coplanar with the seat portion of the support deck or to at least one declined position where in the leg portion is non-coplanar with the seat portion of the support deck. Thepatient control pendant45 may also include TREND UP and TREND DOWN functions which enable the user to orient the support deck and segmented patient support surface to the TRENDELENBURG orientation or REVERSE TRENDELENBURG orientation, as described herein. In the embodiment shown inFIG. 21, thepatient control pendant45 also includes a CHAIR function which positions the upper torso support segment to a fully inclined position with respect to the support deck and upper leg support segment and positions the leg portion of the support deck to a fully declined position with respect to the seat portion of the support deck.
• Still referring toFIG. 21, thetherapy support pendant94 includes TILT UP and TILT DOWN functions which allow a user, specifically a care giver, to increase or decrease the tilt the support deck relative to the base frame.
• Referring again toFIG. 24, the left and right footplate load sensors162,164 are communicatively coupled to thecontrol unit174 and operable to send signals to the control unit indicative of the weight applied to each foot plate. In addition, theLVDTs88,89 of the load frame are communicatively coupled to thecontrol unit174 and operable to send signals to thecontrol unit174 indicative of the weight applied to the load frame. Theweight display201 is communicatively coupled to thecontrol unit174. Theprocessor178 receives the signals from the left and right footplate load sensors162,164 and theLVDTs88,89 and displays the weight registered by these sensors on theweight display201.
• In addition, thecushion sensor166 positioned on the leg portion of the support deck and thestop pin sensor168 of the range of motion stop assembly are also communicatively coupled to thecontrol unit174. In embodiments where the patient support apparatus further comprises alock sensor172, thelock sensor172 is also communicatively coupled to thecontrol unit174. Further, thecontrol system200 may also comprise anexercise mode indicator260 which includes acushion indicator262, astop pin indicator264, a tiltOK indicator266 and, in some embodiments, acarriage lock indicator268, each of which are communicatively coupled to thecontrol unit174. Theexercise mode indicator260 may be positioned on a side rail of the patient support apparatus or, alternatively, on thetherapy control pendant94 or thepatient control pendant45 of the user interface.Indicators262,264,266,268 may be visual indicators, such as LEDs or the like, and/or audible indicators, such as a buzzer or an electronic chime.
• Thecontrol unit174 is operable to receive signals from thecushion sensor166, thestop pin sensor168 and thelock sensor172 and illuminate the corresponding indicator upon the occurrence of a specified condition. For example, in one embodiment, thecushion indicator262 is activated by thecontrol unit174 when the signal received from thecushion sensor166 indicates that the lower leg support segment is not positioned on the leg portion of the support deck. Similarly, thestop pin indicator264 is activated by thecontrol unit174 when the signal received from thestop pin sensor168 indicates that one or more of the stop pins is in a raised position in the path of travel of the carriage. In embodiments where the patient support apparatus includes alock sensor172, thecarriage lock indicator268 is activated by thecontrol unit174 when thelock sensor172 indicates that the carriage lock pin is inserted in the support deck.
• In one embodiment, thecontrol unit174 is programmed to prevent the support deck from being tilted into an exercise orientation until thecushion sensor166, thestop pin sensor168, and thelock sensor172 respectively indicate that the lower leg support segment has been removed from the leg portion of the support deck, at least one stop pin is raised from the support deck and positioned in the path of travel of the carriage, and the carriage lock is not inserted in the support deck. When these conditions are met, thecontrol unit174 activates the tiltOK indicator266 and permits the support deck to be tilted by a user through theuser interface160.
• In another embodiment, when the patient support apparatus additionally comprises alock sensor172, thecontrol unit174 is programmed to prevent the support deck from being tilted into an exercise orientation until thecushion sensor166 and thestop pin sensor168 indicate that the lower leg support segment has been removed from the leg portion of the support deck and at least one stop pin is raised from the support deck and positioned in the path of travel of the carriage. When both of these conditions are met, thecontrol unit174 activates the tiltOK indicator266 and permits the support deck to be tilted by a user through theuser interface160.
• Various orientations of the patient support apparatus will now be described in more detail with specific reference to the figures.
• Referring now toFIG. 6, the patient support apparatus is depicted in a bed orientation. Specifically,FIG. 6 depicts thepatient support apparatus29 in the conventional bed orientation with thesupport deck50 in a neutral orientation (i.e. a substantially horizontal orientation) and theside rail40 in the raised position. Thetorso support segment30 of the segmented patient support surface is elevated by theincline jack motor55 andincline jack sleeve56 such that the torso of the patient is slightly inclined with respect to the patient's legs. This orientation may be achieved by actuating theincline jack motor55 with the HEAD UP function of the patient control pendant. However, it should be understood that thetorso support segment30 may also be lowered to a horizontal position utilizing the HEAD DOWN function of the patient control pendant to actuate theincline jack motor55.
• Referring toFIG. 8, the patient support apparatus is depicted in a reclining chair orientation. In this orientation theleg portion53 of thesupport deck50 is in a decline position which is achieved by actuating thedecline jack motor24 with the LEGS DOWN function of the patient control pendant. In the reclining chair orientation, thetorso support segment30 is in an inclined position such that thetorso support segment30 is non-coplanar with the upperleg support segment31 which may be achieved by actuating theincline jack motor55 with the HEAD UP function of the patient control pendant. In some embodiments, thesupport deck50, and more specifically, theseat portion52 of thesupport deck50 may be tilted with respect to the base frame such that the head end of the seat portion is declined. As shown inFIG. 8, the lower leg support segment is not positioned on theleg portion53 of thesupport deck50. In an alternative embodiment, the reclining chair orientation of the patient support apparatus may be achieved with the CHAIR function of thepatient control pendant45.
• Referring toFIG. 9, the patient support apparatus is positioned in the egress orientation. As with the chair orientation discussed above, the egress orientation is achieved by actuating thedecline jack motor24 with the LEGS DOWN function of the patient control pendant to bringleg portion53 of thesupport deck50 to a maximum decline position while thetorso support segment30 is pivoted to an inclined position such that thetorso support segment30 is non-coplanar with the upperleg support segment31 by actuating theincline jack motor55 with the HEAD UP function of the patient control pendant. However, in the egress orientation, the left and right foot plates are removed from theleg portion53 of the support deck and stowed in the footplate storage weldments225,226. Theright foot plate46 is depicted stowed in the footplate storage weldments225,226 inFIG. 9. Removal of the foot plates allows the feet of the patient to contact the ground and thereby transition to standing. To facilitate the egress orientation theseat portion52 of the support deck is lowered to its lowest position relative to thebase frame61 by using the patient pendant control to actuation of the jack motors. In the embodiment shown inFIG. 9 astanchion44 withhandle44″ is positioned at the end of thebase frame61 to assist the patient in transitioning to a standing position.
• Referring now toFIG. 10, thepatient support apparatus29 is shown in an exercise orientation. In this orientation, thefoot plate assembly41 is positioned on theleg portion53 of thesupport deck50 and theleg portion53 is in the aligned position with respect to theseat portion52 of thesupport deck50. Thesupport deck50 is raised relative to thebase frame61 which may be accomplished by using the BED UP function of the patient control pendant to actuate the jack motors in the load frame. Thetorso support segment30 is in an inclined position such that thetorso support segment30 is non-coplanar with the upperleg support segment31 which may be achieved by actuating theincline jack motor55 with the HEAD UP function of the patient control pendant. The support deck is tilted with respect to the base frame such that the seat portion of the support deck is higher than the leg portion of the support deck. This positioning may be accomplished by actuating thetilt jack motor118 with the TILT UP function of the therapy control pendant. As described hereinabove with respect to the control system depicted inFIG. 24, the TILT UP function of the therapy control unit may be locked out and tilting of the support deck may be prevented by the control until at least the lower leg support segment is removed from theleg portion53 of thesupport deck50 and at least onestop pin182 is positioned in the path of travel of thecarriage18 on thesupport deck50, as is depicted inFIG. 10. Once thecarriage lock mechanism19 has been disengaged, thecarriage18 and the upperleg support segment31 andtorso support segment30 are freely slidable on thepatient support deck50.
• Referring toFIGS. 10 and 16, a patient is depicted seated in thepatient support apparatus29 with the patient support apparatus in the exercise orientation. Specifically, the patient is seated on the upperleg support segment31 such that the patients feet are engaged with thefoot plate assembly41 and the patient is reclined against thetorso support segment30. The patient is secured to thetorso support segment30 withsupport strap16 which is secured tostrap weldments12,13 located at either side of the underside of thetorso support segment30. The patient is depicted performing a closed chain exercise which, in the embodiment shown inFIG. 10, is a leg press exercise. The leg press exercise is accomplished by the patient pressing against thefoot plate assembly41 as the patient straightens his or her legs which, in turn, slides thecarriage18 upwards on thesupport deck50 and away from thefoot plate assembly41. The patient then bends his or her knees to slide thecarriage18 back towards thefoot plate assembly41 in a controlled manner. The brake assembly (not shown) described hereinabove, prevents the rapid acceleration of thecarriage18 with respect to thesupport deck50. In addition, the stop pins182 limit the range of motion of thecarriage18 in the direction towards thefoot plate assembly41. Resistance during the leg press exercise is a fraction of the patient's body weight and is dependent on the tilt angle of thesupport deck50 with respect to thebase frame61. For example, a tilt angle of 20-degrees is approximately 45% body weight and a tilt angle of 35-degrees is approximately 75% body weight. By adjusting the angle of the patient support apparatus with thetilt jack motor118, the patient can perform a leg press exercise with a tolerable amount of resistance to enhance leg strength in preparation for standing. In the embodiment of thepatient support apparatus29 shown inFIG. 10, anangle indicator9 is located at thebearing pivot116 and provides a visual indication of the tilt angle of thesupport deck50 with respect to thebase frame61.Therapy control pendant94 may be used to control thetilt jack motor118 with the TILT UP or TILT DOWN functions, as described above.
• Referring now toFIG. 11A, thepatient support apparatus29 is depicted being used to perform a closed chain exercise which, in this embodiment, is an upper extremity exercise performed with a second type of stationary exercise support, specifically an upper extremity exercise assembly. In this example, at least onestanchion44 is attached to thebase frame61 and an upper extremity exercise assembly is attached to the stanchion. In this embodiment, the upper extremity exercise assembly includes at least onecable59 connected to thecarriage18 ateye bolt120. Thecable59 is routed through at least onepulley58 which is connected to thestanchion44. A free end of thecable59 may include ahandle60 which a patient may grasp. When the patient tensions a free end of thecable59, thecarriage18 slides with respect to the support deck and away from thefoot plate assembly41 thereby sliding the segmented patient support surface with respect to the support deck. The resistance experienced by the patient during this exercise is dependent on the angle of inclination of the support deck, as described above. Closed chain exercises performed with such an apparatus may be used to assist the patient in performing a leg press exercise, as described above, or may be utilized as a stand alone exercise to solely strengthen the upper extremities of the patient, such as when the patient does not engage his or her feet with thefoot plate assembly41.
• Referring now toFIG. 11B, thepatient support apparatus29 is depicted being used to perform a closed chain exercise with yet another type of stationary exercise support which, in this embodiment, is an upper extremity exercise, specifically a pull-up bar assembly. In this example, at least onestanchion44 is attached to thebase frame61 and an upper extremity exercise assembly is attached to the stanchion. In this embodiment, the upper extremity exercise assembly includes a pull-upbar assembly190 attached to thestanchion44. The pull-up bar assembly includes asupport strut194 which is coupled to thestanchion44 with anadjustable fitting196 such that the pull-up bar is vertically adjustable (i.e., in the + or −Z direction of the coordinate axes shown inFIG. 11B). A pull-upbar192 is attached at the opposite end of thesupport strut194 with pull-upbar mount198 such that the pull-up bar is positioned over the patient. The patient may grasp and pull against the pull-up bar assembly thereby sliding the segmented patient support surface with respect to the support deck. The resistance experienced by the patient during this exercise is dependent on the angle of inclination of the support deck, as described above. Closed chain exercises performed with such an apparatus may be used to assist the patient in performing a leg press exercise, as described above, or may be utilized as a stand alone exercise to solely strengthen the upper extremities of the patient, such as when the patient does not engage his or her feet with thefoot plate assembly41.
• Referring now toFIGS. 12 and 17, the patient support apparatus is depicted in use by an amputee patient to perform a unilateral leg strengthening exercise. In this example, the patient support apparatus is oriented in the exercise orientation as described hereinabove with respect toFIG. 10. However, in this example, anamputee support pad4 is attached to thecarriage18. Specifically, theamputee support pad4 is secured into asupport pad receptacle6 located on the free end of the carriage18 (seeFIG. 17). The amputee support pad has a restrainingstrap3 which secures the injured limb and elevates the limb to allow one leg squat exercise to be performed on the patient support apparatus. To perform this function, the footplate on the side of theamputee support pad4 is removed to allow the patient to exercise without the injured limb contacting the footplate. This function can be used for patients with either an amputation or a non-weight-bearing limb, such as a fractured leg or hip, to allow strengthening of the unaffected leg.
• Referring now toFIG. 13, thepatient support apparatus29 is depicted in a tilt orientation wherein the support deck is tilted up to angle of less than 90 degrees with respect to thebase frame61. In some embodiments, the tilt angle of thesupport deck50 is 85 degrees or less. In the tilt orientation the carriage is locked to thesupport deck50 with thecarriage lock mechanism19 thereby preventing movement of the carriage with respect to thesupport deck50. Theleg portion53 of thesupport deck50 is in the aligned position with respect to theseat portion52 of thesupport deck50 which is achieved with the LEGS UP function of the patient control pendant. Thetorso support segment30 is in the recumbent position with respect to the upperleg support segment31 which is achieved with the HEAD DOWN function of the patient control pendant. Thesupport deck50 is tilted with respect to thebase frame61 by actuating thetilt jack motor118 with the TILT UP function of the therapy control pendant. As shown inFIG. 13, the patient is secured to patient support apparatus at the chest, waist and knees with support straps15,16 and17. The straps are secured tostrap weldments12,121,122 located on the underside of the patient support surface.
• The patient support apparatus has been described herein as comprising a support deck to which the torso support segment and the upper leg support segment of a segmented patient surface are slidably coupled. Moreover, the patient support deck has been described as comprising a seat portion and a leg portion which facilitates positioning the patient support apparatus in a chair orientation. However, it should be understood that embodiments of the patient support apparatus which facilitate a leg elevation orientation are also contemplated.
• Referring toFIGS. 25A-25D by way of example, an embodiment of asupport deck50 is depicted which enables a leg elevation function. In this embodiment, thesupport deck50 includes aseat portion52, anintermediate portion54 pivotally coupled to an end of theseat portion52 withhinge20b, and aleg portion53 pivotally coupled to an end of theintermediate portion54 withhinge20a. A conventional lift system (not shown) may be coupled to thesupport deck50 to enable pivoting theintermediate portion54 with respect to theseat portion52 and theleg portion53 with respect to theintermediate portion54 such that theleg portion53 is elevated relative to theseat portion52 to achieve a leg elevation orientation, as depicted inFIG. 25B. Specifically, theintermediate portion54 of thesupport deck50 is positionable in an aligned position wherein theintermediate portion54, theleg portion53 and theseat portion52 are substantially coplanar with one another, as depicted inFIG. 25A. Theintermediate portion54 is also positionable in at least one intermediate position wherein theintermediate portion54 is inclined with respect to theseat portion52 and declined with respect to theleg portion53, as shown inFIG. 25B.
• In this embodiment, a segmentedpatient support surface11 is positioned on thesupport deck50 and comprises atorso support segment30, an upperleg support segment31, and a lowerleg support segment32, and anankle support segment33 as described hereinabove. However, in this embodiment, both the lowerleg support segment32 and theankle support segment33 are removably attached to respective portions of thesupport deck50 so as to enable an exercise orientation of thesupport deck50 and upperleg support segment31. Afoot plate assembly41 may be removably attached to theleg portion53 of thesupport deck50 as described hereinabove.
• In this embodiment, at least thetorso support segment30 and the upperleg support segment31 are slidably coupled to thesupport deck50 such that thetorso support segment30 and the upperleg support segment31 are freely slidable with respect to thesupport deck50, as described hereinabove and shown inFIGS. 25C and 25D. In one embodiment, thetorso support segment30 and the upperleg support segment31 are slidably attached to theseat portion52 withcarriage18. Thecarriage18 is coupled to theseat portion52 with slidingrails21, such as telescopically sliding rails, which enable the carriage to slide relative to thesupport deck50, as described hereinabove. Further, the lift system (not shown) may also be coupled to thetorso support segment30 such that the torso support segment is pivotable with respect to the upper leg support segment from a reclined position wherein the torso support segment and the upper leg support segment are substantially coplanar, as shown inFIG. 25A, and at least one inclined position wherein the torso support segment is non-coplanar with the upper leg support segment as shown inFIG. 25B.
• Patient support apparatuses with support decks of this configuration may have an exercise orientation as depicted inFIG. 25D. Specifically, in the exercise orientation, the lowerleg support segment32 and theankle support segment33 are removed from thesupport deck50 and thetorso support segment30 is in the inclined position with respect to the upperleg support segment31 and theintermediate portion54 of thesupport deck50 is positioned in an aligned position such that theintermediate portion54 is substantially coplanar with theseat portion52 and theleg portion53. Thesupport deck50 is tilted with respect to thebase frame61 such that theseat portion52 of thesupport deck50 is higher that theleg portion53 of thesupport deck50 relative to thebase frame61. Tilting the support deck in this manner may be accomplished withjack motor290 positioned inload frame62, to which thesupport deck50 is pivotally attached. When the patient support apparatus is positioned in the exercise configuration, as depicted inFIG. 25D, the carriage,torso support segment30, and upperleg support segment31 are freely slidable on thesupport deck50 towards and away fromfoot plate assembly41. The patient support apparatus may then be used to perform closed chain exercises, as described hereinabove.
• It should now be understood that the patient support apparatuses described herein can be configured in a bed orientation, a chair orientation, an egress orientation, an exercise orientation, or a tilt orientation. When in the tilt orientation, the patient support apparatus may also be utilized as a tilt table to assist with raising a patient to a standing position. When in the exercise orientation, having the torso support segment and the upper leg support segment slidably coupled to the support deck facilitates use of the patient support apparatus to perform closed chain exercises which utilize a patient's own body weight to increase the strength and range of motion of both upper and lower extremities, and to improve the conditioning of a patient. Further, it should also be understood that the braking assembly incorporated in the patient support apparatus may be used to mitigate rapid acceleration of the torso support segment and the upper leg support segment relative to the support deck thereby providing more uniform resistance throughout the complete range of motion of the exercise.
• It is noted that the terms “substantially” and “about” may be utilized herein to represent the inherent degree of uncertainty that may be attributed to any quantitative comparison, value, measurement, or other representation. These terms are also utilized herein to represent the degree by which a quantitative representation may vary from a stated reference without resulting in a change in the basic function of the subject matter at issue.
• While particular embodiments have been illustrated and described herein, it should be understood that various other changes and modifications may be made without departing from the spirit and scope of the claimed subject matter. Moreover, although various aspects of the claimed subject matter have been described herein, such aspects need not be utilized in combination. It is therefore intended that the appended claims cover all such changes and modifications that are within the scope of the claimed subject matter.

Claims (37)

1. A patient support apparatus with closed chain exercise functionalities, the patient support apparatus comprising:

a base frame;

a support deck supported on the base frame, the support deck comprising a seat portion;

a segmented patient support surface comprising a torso support segment and an upper leg support segment, wherein the torso support segment is pivotable with respect to the upper leg support segment and at least the torso support segment and the upper leg support segment are slidably coupled to the support deck such that the torso support segment and the upper leg support segment are freely slidable with respect to the support deck;

a lift system coupled to the support deck and the segmented patient support surface, the lift system raising, lowering and tilting the support deck with respect to the base frame, and pivoting the torso support segment with respect to the upper leg support segment; and

a foot plate assembly removably positioned proximate a free end of the support deck, the foot plate assembly receiving a patient's feet when a patient is positioned on the segmented patient support surface thereby enabling the patient to slide the segmented patient support surface relative to the support deck to perform a closed chain exercise.

2. The patient support apparatus ofclaim 1, wherein:

the support deck further comprises a leg portion pivotally coupled to an end of the seat portion, the lift system pivoting the leg portion with respect to the seat portion; and

the foot plate assembly is removably positioned on the leg portion of the support deck.

3. The patient support apparatus ofclaim 2, wherein:

the leg portion of the support deck is positionable between an aligned position wherein the leg portion is substantially coplanar with the seat portion and at least one declined position wherein the leg portion is non-coplanar with the seat portion; and

the torso support segment is positionable with respect to the upper leg support segment from a recumbent position wherein the torso support segment and the upper leg support segment are substantially coplanar and at least one inclined position wherein the torso support segment is non-coplanar with the upper leg support segment.

4. The patient support apparatus ofclaim 3, wherein the patient support apparatus has an exercise orientation wherein:

the leg portion of the support deck is in the aligned position with respect to the seat portion of the support deck;

the support deck is tilted with respect to the base frame such that the seat portion of the support deck is higher that the leg portion of the support deck; and

the torso support segment is in the at least one inclined position with respect to the upper leg support segment.

5. The patient support apparatus ofclaim 3, wherein the patient support apparatus has an egress orientation wherein:

the leg portion of the support deck is positioned in the at least one declined position with respect to the seat portion of the support deck; and

the torso support segment of the segmented patient support surface is in the at least one inclined position with respect to the upper leg support segment.

6. The patient support apparatus ofclaim 3, wherein the patient support apparatus has a tilt orientation wherein:

the leg portion of the support deck is in the aligned position with respect to the seat portion of the support deck;

the torso support segment is in the recumbent position with respect to the upper leg support segment; and

the support deck is tilted with respect to the base frame, wherein a tilt angle between the support deck and the base frame is greater than zero and less than or equal to about 90 degrees.

7. The patient support apparatus ofclaim 2, wherein:

the upper leg support segment of the segmented patient support surface is affixed to a carriage; and

the carriage is attached to the seat portion of the support deck with sliding rails such that the carriage and the segmented patient support surface are slidable with respect to the support deck.

8. The patient support apparatus ofclaim 7, wherein the sliding rails are telescoping sliding rails having an extended position wherein the sliding rails are positioned over at least a portion of the leg portion of the support deck and a retracted position wherein the sliding rails are not positioned over the leg portion of the support deck.

9. The patient support apparatus ofclaim 1, wherein:

the support deck further comprises an intermediate portion pivotally coupled to an end of the seat portion and a leg portion pivotally coupled to an end of the intermediate portion, the lift system pivoting the intermediate portion with respect to the seat portion and the leg portion with respect to the intermediate portion; and

the foot plate assembly is removably positioned on the leg portion of the support deck.

10. The patient support apparatus ofclaim 9, wherein:

the intermediate portion of the support deck is positionable between an aligned position wherein the intermediate portion, the leg portion and the seat portion are substantially coplanar with one another and at least one intermediate position wherein the intermediate portion is inclined with respect to the seat portion and declined with respect to the leg portion; and

the torso support segment is positionable with respect to the upper leg support segment from a recumbent position wherein the torso support segment and the upper leg support segment are substantially coplanar and at least one inclined position wherein the torso support segment is non-coplanar with the upper leg support segment.

11. The patient support apparatus ofclaim 10 wherein the patient support apparatus has an exercise configuration wherein:

the intermediate portion of the support deck is positioned in an aligned position;

the support deck is tilted with respect to the base frame such that the seat portion of the support deck is higher that the leg portion of the support deck; and

the torso support segment is in the at least one inclined position with respect to the upper leg support segment.

12. The patient support apparatus ofclaim 9, wherein:

the upper leg support segment of the segmented patient support surface is affixed to a carriage; and

the carriage is attached to the seat portion of the support deck with sliding rails such that the carriage and the segmented patient support surface are slidable with respect to the support deck.

13. The patient support apparatus ofclaim 12, wherein the sliding rails are telescoping sliding rails having an extended position wherein the sliding rails are positioned over at least a portion of the intermediate portion of the support deck and a retracted position wherein the sliding rails are not positioned over the intermediate portion of the support deck.

14. The patient support apparatus ofclaim 1, wherein the support deck is pivotable with respect to the base frame such that the support deck is positionable in at least a neutral orientation wherein the support deck is substantially horizontal, a Trendelenburg orientation wherein a head of the support deck is lower than a foot of the support deck, and a reverse Trendelenburg orientation wherein the foot of the support deck is lower than the head of the support deck.

15. The patient support apparatus ofclaim 1, further comprising a brake assembly regulating a rate of travel of the segmented patient support surface relative to the support deck.

16. The patient support apparatus ofclaim 1, wherein the foot plate assembly comprises at least one load sensor, the at least one load sensor determining a weight applied to the foot plate assembly.

17. The patient support apparatus ofclaim 16, wherein the foot plate assembly comprises a left foot plate and a right foot plate, the left foot plate comprising a left foot load sensor and the right foot plate comprising a right foot load sensor.

18. The patient support apparatus ofclaim 1, further comprising:

at least one stanchion attached to the base frame proximate a head of the base frame; and

an upper extremity exercise assembly attached to the at least one stanchion.

19. The patient support apparatus ofclaim 18, wherein the upper extremity exercise assembly comprises:

at least one pulley supported on the at least one stanchion; and

at least one cable connected to the segmented patient support surface and routed through the at least one pulley, wherein tensioning a free end of the at least one cable causes the segmented patient support surface to slide with respect to the support deck.

20. The patient support apparatus ofclaim 18, wherein the upper extremity exercise assembly comprises a pull-up bar assembly attached to the at least one stanchion, wherein a position of the pull-up bar assembly on the at least one stanchion is vertically adjustable on the at least one stanchion.

21. The patient support apparatus ofclaim 1, wherein the segmented patient support surface further comprises a lower leg support segment.

22. The patient support apparatus ofclaim 1, wherein the support deck further comprises a range of motion stop assembly comprising a plurality of apertures formed in the support deck and at least one stop pin positioned in at least one of the plurality of apertures, wherein the plurality of apertures are spaced at regular intervals in a path of travel of the segmented patient support surface such that, as the segmented patient support surface slides with respect to the support deck, the segmented patient support surface contacts the at least one stop pin thereby limiting a range of motion of the segmented patient support surface.

23. The patient support apparatus ofclaim 1, further comprising a pair of side rails positioned on each side of the support deck, the side rails having a raised position relative to the support deck and a lowered position relative to the support deck.

24. The patient support apparatus ofclaim 1, further comprising a control unit communicatively coupled to the lift system, the control unit controlling the lift system and comprising at least one user interface.

25. The patient support apparatus ofclaim 24, wherein:

the segmented patient support surface further comprises a lower leg support segment removably positioned on the support deck;

the support deck further comprises:

a cushion sensor positioned beneath the lower leg support segment, the cushion sensor determining when the lower leg support segment is positioned on the support deck; and

at least one range of motion stop assembly comprising a plurality of apertures, at least one stop pin, and a stop pin sensor, the stop pin sensor determining when the at least one stop pin is positioned in a path of travel of the segmented patient support surface; and

the stop pin sensor and the cushion sensor are electrically coupled to the control unit and the control unit prevents the support deck from being tilted relative to the base frame until at least the stop pin sensor indicates the at least one stop pin is positioned in one of the plurality of apertures and the cushion sensor indicates the lower leg support segment is not positioned on the support deck.

26. The patient support apparatus ofclaim 25, further comprising:

a carriage lock mechanism releasably securing the segmented patient support surface to the support deck such that the segmented patient support surface does not slide with respect to the support deck; and

a lock sensor communicatively coupled to the control unit, wherein the control unit is programmed to prevent the support deck from being tilted relative to the base frame until the stop pin sensor indicates the at least one stop pin is positioned in one of the plurality of apertures, the cushion sensor indicates the lower leg support segment is not positioned on the support deck, and the lock sensor indicates the segmented patient support surface is secured to the support deck.

27. A patient support apparatus with closed chain exercise functionalities, the patient support apparatus comprising:

a base frame;

a support deck supported on the base frame, the support deck comprising a seat portion and a leg portion pivotally coupled to an end of the seat portion;

a segmented patient support surface comprising an upper leg support segment slidably coupled to the support deck such that the upper leg support segment is freely slidable with respect to the support deck;

a lift system coupled to the support deck and the segmented patient support surface, the lift system raising, lowering and tilting the support deck with respect to the base frame and pivoting the leg portion with respect to the seat portion; and

a foot plate assembly removably positioned proximate a free end of the leg portion of the support deck, the foot plate assembly receiving the feet of a patient when the patient is positioned on the segmented patient support surface thereby enabling the patient to slide the segmented patient support surface relative to the support deck to perform a closed chain exercise.

28. The patient support apparatus ofclaim 27, wherein the patient support apparatus has an exercise orientation wherein:

the leg portion of the support deck is in the aligned position with respect to the seat portion of the support deck; and

the support deck is tilted with respect to the base frame such that the seat portion of the support deck is higher that the leg portion of the support deck.

29. The patient support apparatus ofclaim 27, wherein the patient support apparatus has an egress orientation wherein:

the leg portion of the support deck is positioned in the at least one declined position with respect to the seat portion of the support deck; and

the support deck is at its lowered position with respect to the base.

30. The patient support apparatus ofclaim 27, wherein the patient support apparatus has a tilt orientation wherein:

the leg portion of the support deck is in the aligned position with respect to the seat portion of the support deck; and

the support deck is tilted with respect to the base frame, wherein a tilt angle between the support deck and the base frame is greater than zero and less than or equal to about 90 degrees.

31. A patient support apparatus with closed chain exercise functionalities, the patient support apparatus comprising:

a base frame;

a support deck supported on the base frame, the support deck comprising a seat portion;

a segmented patient support surface comprising a torso support segment and an upper leg support segment is supported on the support deck, wherein the torso support segment is pivotable with respect to the upper leg support segment;

a lift system coupled to the support deck and the segmented patient support surface, the lift system raising, lowering and tilting the support deck with respect to the base frame, and pivoting the torso support segment with respect to the upper leg support segment; and

a stationary exercise support positioned to be engaged by a patient when the patient is positioned on the segmented patient support surface such that the patient can perform a closed chain exercise while positioned on the segmented patient support surface.

32. The patient support apparatus ofclaim 31, wherein:

at least the torso support segment and the upper leg support segment are slidably coupled to the support deck such that the torso support segment and the upper leg support segment are freely slidable with respect to the support deck; and

the stationary exercise support assembly permits the patient to slide the segmented patient support surface relative to the support deck to perform a closed chain exercise.

33. The patient support apparatus ofclaim 32, wherein:

the upper leg support segment of the segmented patient support surface is affixed to a carriage; and

the carriage is attached to the seat portion of the support deck with sliding rails such that the carriage and the segmented patient support surface are slidable with respect to the support deck.

34. The patient support apparatus ofclaim 33, wherein the sliding rails are telescoping sliding rails having an extended position wherein the sliding rails are positioned over at least a portion of the leg portion of the support deck and a retracted position wherein the sliding rails are not positioned over the leg portion of the support deck.

35. The patient support apparatus ofclaim 31, wherein the stationary exercise support is a foot plate assembly removably positioned proximate a free end of the support deck, the foot plate assembly receiving a patient's feet when a patient is positioned on the segmented patient support surface.

36. The patient support apparatus ofclaim 35, wherein the foot plate assembly comprises a left foot plate and a right foot plate, the left foot plate comprising a left foot load sensor and the right foot plate comprising a right foot load sensor.

37. The patient support apparatus ofclaim 31, wherein the stationary exercise support is a pull-up bar assembly attached to at least one stanchion, wherein a position of the pull-up bar assembly on the at least one stanchion is vertically adjustable on the at least one stanchion.

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